Infections after intramedullary fixation of trochanteric fractures are uncommon and implant removal is not usually needed.

Abstract

Infections after intramedullary fixation of trochanteric femoral fractures are rare, but potentially life-threatening complications. There are limited data available to support decision making in these cases. A retrospective study of 995 consecutive operatively treated trochanteric fractures was made to find out different risk factors for infection and to describe the results of treatment. 28 patients developed a surgical site infection (2.8%) after intramedullary fixation of trochanteric fracture. 15 patients (1.5%) had a deep and 13 patients (1.3%) a superficial surgical site infection. Cigarette smoking (p<0.05) and prolonged operative time (p<0.05) were significant risk factors for an infection. 15 of 28 patients needed revision surgeries. Implant removal or exchange was needed only for 4 of 28 patients: 1 exchange of the blade, 1 removal of additional cable used to assist reduction and 2 removals of distal locking screws. None of the patients needed additional surgeries for problems with fracture healing. Mortality was not increased among patients with an infection. Infection after intramedullary fixation of trochanteric fractures can be successfully treated without removal or exchange of the fixation material.